Displaying 3381 - 3400 of 5993
Contract Number Brand Code Brand Name Package Size Formulary Category Unit Price Strength Max. Reimbursable / Month Drug Contract Start Date Drug Contract End Date Restrict To Ophthalmologist Restrict To Pulmonologist Status Description Max Repeats
42 5231ZG KETOZAL 2% CR (CAR) KETOCONAZOLE (C) 45G C 8.89 2% 2 2026-04-01 No No 0
41 5231ZH CLODERM 1% CR (CAR) CLOTRIMAZOLE (C) 15G C 3.0717 1% 2 2024-04-01 2026-03-31 0
42 5231ZH CLODERM 1% CR (CAR) CLOTRIMAZOLE (C) 15G C 3.18 1% 2 2026-04-01 No No 0
40 5231ZJ MICOSPEC 2% CR (CAR/COL) MICONAZOLE 15G C 3.64 2%/G 0 2022-04-01 2024-03-31 0
41 5231ZJ MICOSPEC 2% CR (CAR) MICONAZOLE (C) 15G C 3.6697 2% 2 2024-04-01 2026-03-31 0
42 5231ZJ MICOSPEC 2% CR (CAR) MICONAZOLE 15G A 3.67 2% 2 2026-04-01 No No 0
40 5231ZK MICONAZOLE 2% CR (CIP/AHI) 15G A 2.12 2% 2 2022-04-01 2024-03-31 0
40 52324 ECONADERM 1% SOLN (CAR/COL) ECONAZOLE 20ML A 5.16 1% 2 2022-04-01 2024-03-31 0
41 52324 ECONADERM 1% SOLN (CAR) ECONAZOLE 20ML A 5.3823 1% 2 2024-04-01 2026-03-31 0
42 52324 ECONADERM 1% SOLN (CAR) ECONAZOLE 20ML A 5.38 1% 2 2026-04-01 2028-03-31 No No 0
40 5232AA BATRAFEN NAIL LACQUER 8% (SFA/COL) CICLOPIROX OLAMINE 3ML C 33.98 8% 0 2022-04-01 2024-03-31 0
40 5232AC LAMISIL 1% SPRAY (GSK/COL) TERBINAFINE 30ML C 34.11 1% 0 2022-04-01 2024-03-31 0
41 5232AC LAMISIL 1% SPRAY (GSK) TERBINAFINE (C) 30ML C 35.8003 1% 0 2024-04-01 2026-03-31 0
40 5232AZ CANDID 1% EAR DR (GLP/ALI) CLOTRIMAZOLE 15ML A 6.80 1% 1 2022-04-01 2022-03-22 Delete from contract 0
40 5232BA KETOCONAZOLE 2% SHAMP (HEA/RXP) 100ML A 0.05 2% 100 2022-04-01 2024-03-31 6
40 5232BE KETOZAL 2% SHAMP (CAR/COL) KETOCONAZOLE 250ML C 0.08 2% 0 2022-04-01 2024-03-31 0
41 5232BE KETOZAL 2% SHAMP (CAR) KETOCONAZOLE (C) 250ML C 0.0868 2% 100 2024-04-01 2026-03-31 6
42 5232BE KETOZAL 2% SHAMP (CAR) KETOCONAZOL (C) 250ML C 0.09 2% 100 2026-04-01 No No 6
40 5232BF TERBINAFINE 1% LOTION (AUR/AHI) 30ML C 5.08 1% 0 2022-04-01 2024-03-31 0
41 5232BF TERBINAFINE 1% LOTION (AUR) 30ML A 5.2464 1% 1 2024-04-01 2026-03-31 6